This collection complements New Essays in Philosophical Theology by displaying the influence of the later Wittgenstein on contemporary philosophers of religion. The first two papers are Peter Winch's "Understanding a Primitive Society" and Norman Malcolm's "Anselm's Ontological Arguments". Distinguishing between interpretations of experience within a system of concepts and the reality expressed by the limiting concepts presupposed by such a system, Winch will not allow us to question the validity of the portrayal of reality as such and specifically attacks MacIntyre's (...) dismissal of magic. Neither Winch nor Malcolm leave room for changes in our conception of the reality expressed which might lead to radical reappraisal of the concepts used. Building on Malcolm, the editor declares theoretical speculation and scepticism to be incompatible with religious understanding. After a typically sterile debate between Atheist, Agnostic, Protestant and Catholic and a typically judicious paper by Kemp Smith on "Is Divine Existence Credible?" we come to the gem of the collection, W. H. Poteat's "Birth, Suicide and the Doctrine of Creation: An Exploration of Analogies." This and the next unravel ambiguities in our talk of the world. Then come R. F. Holland on "The Miraculous" and some vintage Collingwood on "The Devil". Phillips on moral and religious conceptions of duty and Poteat's analysis of "I Will Die" complete the series. Almost all of the essays have been previously published, but the editor has done a good job of gathering and arranging them in a meaningful sequence. Apart from Kemp Smith and Collingwood, the writers represent "Wittgensteinian Fideism" and the book suffers for lack of the criticism of this that Kai Nielsen or MacIntyre might have supplied. Its most suggestive passages are those in which linguistic and existentialist insights are married. But the marriage is still without metaphysical issue.—C. P. S. (shrink)

Essentially a history of religion in the twentieth century, this erudite work puts more emphasis on religion than on change and more faith in Christianity than in other traditions. Alive to the importance of the ecumenical movement and the Second Vatican Council, Edwards argues that no other religious groups in our time have the sophistication of the major Christian denominations in responding to the challenges of a scientifically based culture and an industrialized economy. He relates the major movements in modern (...) theology to a context informed by Marx and Freud, biology and technology, Eastern spirituality and Western revivalism. But he evades the challenge to revise our concept of God or demonstrate the meaningfulness of the traditional concept, with the plea that today's theologians have to be more humble than their predecessors in making dogmatic claims. From his vantage-point in England he judiciously assesses currents of thought in Europe and the United States, while showing more sensitivity to the views of British humanists than to the crises of faith and morals arising in contemporary political and social life. Despite his familiarity with the "new" morality and literary celebrations of the "death" of God, he ends with a relatively unperturbed affirmation of the biblical message concerning Jesus' death and resurrection. The result is a highly competent survey of how things stand at present for Western churchmen and theologians. The book has a few typographical and other errors, notably the placing of the last line first on page 260 and the footnote references to Sir Humphrey rather than Hamilton Gibb and to Robert rather than Richard Robinson.--C. P. S. (shrink)

Although most people still behave like happy meat eaters, there are good reasons to think that many are in fact ambivalent about meat. Following up on earlier findings, in this paper we describe how, in focus groups, cultured meat triggered much discussion about meat, especially among older people. While young people wondered whether they would eat cultured meat products, older people thought about diet changes in a historical perspective and wondered if and how cultured meat might become a societal success. (...) Beneath the surface of everyday behavior, in which they followed mainstream norms, many of our research participants harbored moral concerns and in various ways expressed an interest in collective change. Reflecting on the focus group discussions, we suggest, first, that appreciating the important role of ambivalence in processes of moral change requires rethinking relations between ambivalence and morality. Second, the entanglement of ambivalence with ambiguity increases the “fluidity” of such processes of change: when it is no longer clear what exactly meat is, the meanings and experiences of eating it also become unsettled. This has implications for thinking about morality in times of change. Studying consumer choices cannot do justice to processes of ambivalence and ambiguity below the surface of behavior. More generally, the idea that morality resides in making up our minds about clear moral choices gives way to the need to become skilled, collectively as well as individually, in dealing imaginatively with ambivalence and ambiguity. (shrink)

Although the Neo-Darwin Theory of Evolution is one of the most celebrated theories in science, nonetheless it has received many criticisms. These criticisms are documented and a new transdisciplinary theory of origin is introduced. Darwin's original argument was that natural selection, through heritable changes, changed simple organisms over time. These heritable changes are responsible for the complex plethora of life seen around us today. Darwin's original theory, however, was deconstructed after the fact into a mutation-based theory. This mutation-based theory in (...) its current form is an insufficient and indeed unnecessary transdisciplinary explanation. A subsequent statistical comparison between the six extant scientifically based primary theories of origin was undertaken and based on current biological knowledge a statistically significantly best fit phenotypic model emerged. (shrink)

The experience of the use of applied containerized biomedical software tools in cloud environment is summarized. The reproducibility of scientific computing in relation with modern technologies of scientific calculations is discussed. The main approaches to biomedical data preprocessing and integration in the framework of the intelligent analytical system are described. At the conditions of pandemic, the success of health care system depends significantly on the regular implementation of effective research tools and population monitoring. The earlier the risks of disease can (...) be identified, the more effective process of preventive measures or treatments can be. This publication is about the creation of a prototype for such a tool within the project «Development of methods, algorithms and intelligent analytical system for processing and analysis of heterogeneous clinical and biomedical data to improve the diagnosis of complex diseases», implementted by the V.M. Glushkov Institute of Cybernetics, National Academy of Sciences of Ukraine, together with the United Institute of Informatics Problems, National Academy of Sciences of Belarus. The insurers, entering the market, can insure mostly low risks by facilitating more frequent changes of insurers by consumers and mixing the overall health insurance market. Socio-demographic variables can be risk adjusters. Since age and gender have a relatively small explanatory power, other socio-demographic variables were studied – marital status, retirement status, disability status, educational level, income level. Because insurers have an interest in beneficial diagnoses for their policyholders, they are also interested in the ability to interpret relevant information – upcoding: insurers can encourage their policyholders to consult with doctors more often to select as many diagnoses as possible. Many countries and health care systems use diagnostic information to determine the reimbursement to a service provider, revealing the necessary data. For processing and analysis of these data, software implementations of construction for classifiers, allocation of informative features, processing of heterogeneous medical and biological variables for carrying out scientific research in the field of clinical medicine are developed. The experience of the use of applied containerized biomedical software tools in cloud environment is summarized. The reproducibility of scientific computing in relation with modern technologies of scientific calculations is discussed. Particularly, attention is paid to containerization of biomedical applications, this permits to get reproducibility of the conditions in which the calculations took place, technologies of software pipelining of calculations, that allows to organize flow calculations, and technologies for parameterization of software environment, that allows to reproduce, if necessary, an identical computing environment. The main approaches to biomedical data preprocessing and integration in the framework of the intelligent analytical system are described. The experience of using the developed linear classifier, gained during its testing on artificial and real data, allows us to conclude about several advantages provided by the containerized form of the created application: it permits to provide access to real data located in cloud environment; it is possible to perform calculations to solve research problems on cloud resources both with the help of developed tools and with the help of cloud services; such a form of research organization makes numerical experiments reproducible, i.e. any other researcher can compare the results of their developments on specific data that have already been studied by others, in order to verify the conclusions and technical feasibility of new results; there exists a universal opportunity to use the developed tools on technical devices of various classes from a personal computer to powerful cluster. (shrink)

Background: Despite a gradual shift in the focus of medical care among terminally ill patients to a palliative model, studies suggest that many children with life-limiting chronic illnesses continue to die in hospital after prolonged periods of inpatient admission and mechanical ventilation.Objectives: To examine the characteristics and location of death among hospitalised children, investigate yearwise trends in these characteristics and test the hypothesis that professional ethical guidance from the UK Royal College of Paediatrics and Child Health would lead to significant (...) changes in the characteristics of death among hospitalised children.Methods: Routine administrative data from one large tertiary-level UK children’s hospital was examined over a 7-year period for children aged 0–18 years. Demographic details, location of deaths, source of admission , length of stay and final diagnoses were studied. Statistical significance was tested by the Kruskal–Wallis analysis of ranks and median test , χ2 test and Cochran–Armitage test .Results: Of the 1127 deaths occurring in hospital over the 7-year period, the majority were among infants. The main diagnoses at death included congenital malformations , perinatal diseases , cardiovascular disorders and neoplasms . Most deaths occurred in an intensive care unit environment , with a significant increase over the years . There was a clear increase in the proportion of admissions from in-hospital among the ICU cohort . Infants with congenital malformations and perinatal conditions were more likely to die in an ICU , and older children with malignancy outside the ICU . Children stayed for a median of 13 days on a hospital ward before being admitted to an ICU where they died.Conclusions: A greater proportion of hospitalised children are dying in an ICU environment. Our experience indicates that professional ethical guidance by itself may be inadequate in reversing the trends observed in this study. (shrink)

In the literature on the recovery of societies from natural disasters, a dominant theme is the importance of pursuing and achieving sustainable recovery. Sustainability implies that recovery efforts should aim to (re-) build, maintain, and, if possible, enhance the quality of life of members of the disaster-stricken community in the short and long term. In this paper, we propose a capabilities-based approach to recovery and argue that it provides important theoretical resources for better realizing this ideal of sustainability in practice. (...) From a capabilities-based approach, the societal impact of a disaster is measured in terms of its impact on selected capabilities of individuals within society. Capabilities are constitutive elements of well-being and capture the valuable doings and beings individuals can achieve or become (e.g., being adequately nourished, and being sheltered). A proposed Disaster Impact Index (DII), we argue, can capture the societal impact of a disaster by measuring its impact on the well-being of individuals, as gauged by the changes in individuals’ capabilities. We discuss how to measure this impact in practice. Also, a proposed Disaster Recovery Index (DRI) measures the current level of individuals’ capabilities. It can provide important information on the degree to which capabilities have been restored and enhanced by comparing the DRI against a benchmark, or level of capabilities attainment, toward which recovery processes should strive. We argue that the DII and DRI provide critical information for policy- and decision-makers to use in order to practically implement the principles of sustainable recovery. Both can be used in the process of predisaster planning for recovery and in the period of recovery itself. (shrink)

The purpose of this study was to develop a Physician's Spiritual Well-Being Scale (PSpWBS). The significance of a physician's spiritual well-being was explored through in-depth interviews with and qualitative data collection from focus groups. Based on the results of qualitative analysis and related literature, the PSpWBS consisting of 25 questions was established. Reliability and validity tests were performed on 177 subjects. Four domains of the PSpWBS were devised: physician's characteristics; medical practice challenges; response to changes; and overall well-being. The explainable (...) total variance was 65.65%. Cronbach α was 0.864 when the internal consistency of the whole scale was calculated. Factor analysis showed that the internal consistency Cronbach α value for each factor was between 0.625 and 0.794 and the split-half reliability was 0.865. The scale has satisfactory reliability and validity and could serve as the basis for assessment of the spiritual well-being of a physician. (shrink)

\noindent\textbf{Introduction} Online interventions hold great potential for Therapeutic Change Process Research (TCPR), a field that aims to relate in-therapeutic change processes to the outcomes of interventions. Online a client is treated essentially through the language their counsellor uses, therefore the verbal interaction contains many important ingredients that bring about change. TCPR faces two challenges: how to derive meaningful change processes from texts, and secondly, how to assess these complex, varied and multi-layered processes? We advocate the use text mining and multi-level (...) models (MLMs): the former offers tools and methods to discovers patterns in texts; the latter can analyse these change processes as outcomes that vary at multiple levels. \noindent\textbf{Method} We (re-)used the data from \cite{Lamers2015} because it includes outcomes and the complete online intervention for clients with mild depressive symptoms. We used text mining to obtain basic text-variables from e-mails, that we analysed through MLMs. \noindent\textbf{Results} We found that we could relate outcomes of interventions to variables containing text-information. We conclude that we can indeed bridge text mining and MLMs for TCPR as it was possible to relate text-information (obtained through text mining) to multi-levelled TCPR outcomes (using a MLM). \noindent\textbf{Discussion} Text mining can be helpful to obtain change processes, which is also the main challenge for TCPR. We showed how MLMs and text mining can be combined, but our proposition leaves open how to obtain the most relevant textual operationalization of TCPR concepts. That requires interdisciplinary collaboration and discussion. The future does look bright: based on our proof-of-concept study we conclude that MLMs and text mining can indeed advance TCPR. (shrink)

BackgroundReducing the number of animals used in experiments has become a priority for the governments of many countries. For these reductions to occur, animal-free alternatives must be made more available and, crucially, must be embraced by researchers.MethodsWe conducted an international online survey for academics in the field of animal science (N = 367) to explore researchers’ attitudes towards the implementation of animal-free innovations. Through this survey, we address three key questions. The first question is whether scientists who use animals in (...) their research consider governmental goals for animal-free innovations achievable and whether they would support such goals. Secondly, responders were asked to rank the importance of ten roadblocks that could hamper the implementation of animal-free innovations. Finally, responders were asked whether they would migrate (either themselves or their research) if increased animal research regulations in their country of residence restricted their research.ResultsWhile nearly half (40%) of the responders support governmental goals, the majority (71%) of researchers did not consider such goals achievable in their field within the near future. In terms of roadblocks for implementation of animal-free methods, ~ 80% of the responders considered ‘reliability’ as important, making it the most highly ranked roadblock. However, all other roadblocks were reported by most responders as somewhat important, suggesting that they must also be considered when addressing animal-free innovations. Importantly, a majority reported that they would consider migration to another country in response to a restrictive animal research policy. Thus, governments must consider the risk of researchers migrating to other institutes, states or countries, leading to a ‘brain-drain’ if policies are too strict or suitable animal-free alternatives are not available.ConclusionOur findings suggest that development and implementation of animal-free innovations are hampered by multiple factors. We outline three pillars concerning education, governmental influence and data sharing, the implementation of which may help to overcome these roadblocks to animal-free innovations. (shrink)

Introduction: Although deep brain stimulation often improves levodopa-responsive gait symptoms, robust therapies for gait dysfunction from Parkinson's disease remain a major unmet need. Walking speed could represent a simple, integrated tool to assess DBS efficacy but is often not examined systematically or quantitatively during DBS programming. Here we investigate the reliability and functional significance of changes in gait by directional DBS in the subthalamic nucleus.Methods: Nineteen patients underwent unilateral subthalamic nucleus DBS surgery with an eight-contact directional lead in the most (...) severely affected hemisphere. They arrived off dopaminergic medications >12 h preoperatively and for device activation 1 month after surgery. We measured a comfortable walking speed using an instrumented walkway with DBS off and at each of 10 stimulation configurations at the midpoint of the therapeutic window. Repeated measures of ANOVA contrasted preoperative vs. maximum and minimum walking speeds across DBS configurations during device activation. Intraclass correlation coefficients examined walking speed reliability across the four trials within each DBS configuration. We also investigated whether changes in walking speed related to modification of step length vs. cadence with a one-sample t-test.Results: Mean comfortable walking speed improved significantly with DBS on vs. both DBS off and minimum speeds with DBS on. Pairwise comparisons showed no significant difference between DBS off and minimum comfortable walking speed with DBS on. Intraclass correlations were ≥0.949 within each condition. Changes in comfortable walk speed were conferred primarily by changes in step length.Conclusion: Acute assessment of walking speed is a reliable, clinically meaningful measure of gait function during DBS activation. Directional and circular unilateral subthalamic DBS in appropriate configurations elicit acute and clinically significant improvements in gait dysfunction related to PD. Next-generation directional DBS technologies have significant potential to enhance gait by individually tailoring stimulation parameters to optimize efficacy. (shrink)

The study of the interrelationship between ethnomedicinal knowledge and socio-cultural values needs to be studied mainly for the simple reason that culture is not only the ethical imperative for development, it is also the condition of its sustainability; for their exists a symbiotic relationship between habitats and cultures. The traditional communities around Binsar Wildlife Sanctuary of Uttarakhand state in India have a rich local health care tradition, which has been in practice for the past hundreds of years. The present study (...) documents the Ethnomedicinal uses of 54 medicinal and aromatic plants (MAPs) along with their botanical and vernacular names, family, habit, habitat, threat status, collection season, purpose of collection, quantity, conservation practices, market potential and part(s) used in traditional health care system. The documented species belonging to 38 families have been used to cure more than 47 different kinds of ailments. These MAPs collected from the wild in a particular season and used as per the method prescribed by traditional herbal healers (Vaidyas) that provide effective results. Perception of local people during field trips based on socio-demographic characters showed them to prefer herbal system of treatments and they understood the status of traditional health care systems in the region. The study reveals that approximately 70 % population of the study area depend on herbal systems of treatments and preferred to visit Vaidyas for curing a variety of ailments because the traditional system of medicine is one of the most important prevailing systems in the region where modern health care facilities are rare or in very poor conditions. The organic cultivation practices of selected MAPs were demonstrated to rural inhabitants through capacity building training program and participatory action research framework approaches for sustainability and enhancement of livelihood security. A series of workshops and village level meetings on traditional health care systems were organized and forming/registered a strong association of Vaidyas for making their traditional system of health care more practical and effective. The study emphasizes the potentials of the ethnomedicinal research, conservation practices, socio-cultural and religious ethics for promoting traditional plants based treatments and also the need to document the indigenous knowledge for scientific validation before its industrial application. (shrink)

One of the gains to be reckoned from the study of nomenclature in the sepulchral inscriptions of the early empire is the gradual abandonment of attempts to distinguish between slave and freeborn on the basis of personal name or cognomen alone, especially when this is of Latin derivation. Nevertheless, one still finds personal cognomina in undated inscriptions adduced as sole evidence for the origin or status of individuals below senatorial rank. Thus in a standard work on freedmen in the early (...) empire, recently reprinted, names such as Agilis, Amandus, Auctus, Communis, Donatus, Faustus, Felix, etc., are said to be commonly servile, but others such as Aquila, Bassus, Capito, Cams, Celer, Crescens, etc., are taken as ingenuous. The criteria used in making such a distinction are subjective and arbitrary and the statistics based on them are largely valueless. It is the purpose of this note to consider briefly on this question the evidence of the personal nomenclature of the Imperial slaves and freedmen. In this group, the Familia Caesaris, no problem of status arises, and the fact that the majority of their inscriptions can be dated, at least approximately, makes it possible to trace the chronological development of the use of cognomina ingenua by one important group of servile origin from the first to the early third century A.D. Moreover, such a development is useful evidence for change in the social structure of the early empire. (shrink)

Change blindness illustrates a remarkable limitation in visual processing by demonstrating that substantial changes in a visual scene can go undetected. Because these changes can ultimately be detected using top–down driven search processes, many theories assign a central role to spatial attention in overcoming change blindness. Surprisingly, it has been reported that change blindness can occur during blink-contingent changes even when observers fixate the changing location [O’Regan, J. K., Deubel, H., Clark, J. J., & Rensink, R. A. . Picture changes (...) during blinks: Looking without seeing and seeing without looking. Visual Cognition, 7, 191–212]. However, eye blinks produce a transient disruption of vision that is independent of any associated changes in the retinal image. We determined whether these ‘attentive blank stares’ could occur in the absence of blink-mediated visual suppression. Using a flicker change-blindness paradigm we confirm that despite direct attentive fixations, obvious scene changes often remain undetected. We conclude that change detection involves object or feature based attentional mechanisms, which can be ‘misdirected’ despite the allocation of spatial attention to the position of the change. (shrink)

Joseph Beuys was one of the most significant artists of the 20th century. He was a gunner and radio operator in the German Air Force during World War II, and was severely injured several times. In March 1943 he had a life-changing experience after the dive bomber he was assigned to crashed in the Crimean peninsula. This trauma influenced Beuys' entire artistic career, and is known in art history as the ’Tartar Legend’ or ’Tartar Myth’. Profoundly affected by the crash, (...) the severe trauma, the near-death experience and his rescue, which he perceived as a “rebirth”, Beuys no longer saw himself, other people or society as a whole in the same way as previously. With his new consciousness, he ignored boundaries and created visions whereby all mankind could experience the healing he had undergone. Beuys did not bring society far enough for the turning point towards “the healing of the world” to be visible, yet today it is important to keep his work alive as a record of his extraordinary strength, which arose from trauma and severe injury, and was carried by a passionate commitment to mankind and to life itself. (shrink)

The COVID-19 pandemic has exacerbated levels of stress and anxiety for P-12 teachers around the globe. The present study aims to understand teachers’ emotional experiences and feelings of burnout during the pandemic, and how individual (i.e., emotion regulation strategies) or contextual factors (e.g., school administrative support) intersect with different facets of their emotional experiences. Using a sequential explanatory mixed methods design, we collected and examined survey and interview data from teachers in the southeastern United States. The structural equation model confirmed (...) the relationships among the following latent variables: negative emotion, emotion regulation, autonomy support, burnout, and teacher enthusiasm. Qualitative findings provide further insight in the contextualized nature of these relationships and how they play out across various schools and districts. (shrink)

L S Penrose’s Limit Theorem – which is implicit in Penrose [7, p. 72] and for which he gave no rigorous proof – says that, in simple weighted voting games, if the number of voters increases indefinitely and the relative quota is pegged, then – under certain conditions – the ratio between the voting powers of any two voters converges to the ratio between their weights. Lindner and Machover [4] prove some special cases of Penrose’s Limit Theorem. They give a (...) simple counter-example showing that the theorem does not hold in general even under the conditions assumed by Penrose; but they conjecture, in effect, that under rather general conditions it holds ‘almost always’ – that is with probability 1 – for large classes of weighted voting games, for various values of the quota, and with respect to several measures of voting power. We use simulation to test this conjecture. It is corroborated with respect to the Penrose–Banzhaf index for a quota of 50% but not for other values; with respect to the Shapley–Shubik index the conjecture is corroborated for all values of the quota. (shrink)

Understanding the evolutionary role of environmentally induced phenotypic variation (i.e., plasticity) is an important issue in developmental evolution. A major physiological response to environmental change is cellular stress, which is counteracted by generic stress reactions detoxifying the cell. A model, stress‐induced evolutionary innovation (SIEI), whereby ancestral stress reactions and their corresponding pathways can be transformed into novel structural components of body plans, such as new cell types, is described. Previous findings suggest that the cell differentiation cascade of a cell type (...) critical to pregnancy in humans, the decidual stromal cell, evolved from a cellular stress reaction. It is hypothesized that the stress reaction in these cells was elicited ancestrally via inflammation caused by embryo attachment. The present study proposes that SIEI is a distinct form of plasticity‐based evolutionary change leading to the origin of novel structures rather than adaptive transformation of pre‐existing characters. (shrink)

One of the most profound insights of the dynamic systems perspective is that new structures resulting from the developmental process do not need to be planned in advance, nor is it necessary to have these structures represented in genetic or neurological templates prior to their emergence. Rather, new structures can emerge as components of the individual and the environment self-organize; that is, as they mutually constrain each other's actions, new patterns and structures may arise. This theoretical possibility brings into developmental (...) theory the important concept of indeterminism--the possibility that developmental outcomes may not be predictable in any simple linear causal way from their antecedents. This is the first book to take a critical and serious look at the role of indeterminism in psychological and behavioral development. * What is the source of this indeterminism? * What is its role in developmental change? * Is it merely the result of incomplete observational data or error in measurement? It reviews the concepts of indeterminism and determinism in their historical, philosophical, and theoretical perspectives--particularly in relation to dynamic systems thinking--and applies these general ideas to systems of nonverbal communication. Stressing the indeterminacy inherent to symbols and meaning making in social systems, several chapters address the issue of indeterminism from metaphorical, modeling, and narrative perspectives. Others discuss those indeterministic processes within the individual related to emotional, social, and cognitive development. (shrink)

One of the standard principles of rationality guiding traditional accounts of belief change is the principle of minimal change: a reasoner's belief corpus should be modified in a minimal fashion when assimilating new information. This rationality principle has stood belief change in good stead. However, it does not deal properly with all belief change scenarios. We introduce a novel account of belief change motivated by one of Grice's maxims of conversational implicature: the reasoner's belief corpus is modified in a minimal (...) fashion to assimilate exactly the new information. In this form of belief change, when the reasoner revises by new information p ∨ q their belief corpus is modified so that p∨q is believed but stronger propositions like p∧q are not, no matter what beliefs are in the reasoner's initial corpus. We term this conservative belief change since the revised belief corpus is a conservative extension of the original belief corpus given the new information. (shrink)

BackgroundAs moral case deliberations (MCDs) have increasingly been implemented in health care institutions as a form of ethics support, it is relevant to know whether and how MCDs actually contribute to positive changes in care. Insight is needed on what actually happens in daily care practice following MCD sessions. This study aimed at investigating the impact of MCD and exploring how ‘impact of MCD’ should be conceptualized for future research.MethodsA multiple-case study was conducted in a care organization for people with (...) intellectual disabilities and/or acquired brain injury, by observing MCD sessions as ‘cases’, followed by interviews with health care professionals concerning the follow-up to these cases, and a focus group with involved MCD facilitators. A conceptual scheme concerning the possible impact formed the basis for analysis: (1) individual moral awareness; (2) the actions of health care professionals; (3) collaboration among health care professionals; (4) the concrete situation of the client; (5) the client’s quality of care and life; (6) the organizational and policy level.ResultsAccording to interviewees, their moral awareness and their collaboration, both among colleagues and with clients’ relatives, improved after MCD. Perceived impact on client situation, quality of care/life and the organizational level varied among interviewees or was difficult to define or link to MCD. Three aspects were added to the conceptual scheme concerning the impact of MCD: (a) preparations and expectations prior to the MCD session; (b) a translational step between the conclusions of the MCD session and practical events in the following period, and (c) collaboration with clients’ relatives. A negative impact of MCD was also found on misunderstandings among participants and disappointment about lack of follow-up.ConclusionsConcretizing and conceptualizing the ‘impact’ of MCD is complicated as many factors play a role either before or during the transition from MCD to practice. It is important to consider ‘impact’ in a broad sense and to relate it to the goals and context of the MCD in question. Future studies in this field should pay additional attention to the preparations, content and process involved in ethics support, including clients’ and relatives’ experiences. (shrink)

Early versions of satellite and radiosonde datasets suggested that the tropical surface had warmed more than the troposphere, while climate models consistently showed tropospheric amplification of surface warming in response to human-caused increases in greenhouse gases. We revisit such comparisons here using new observational estimates of surface and tropospheric temperature changes. We find that there is no longer a serious discrepancy between modeled and observed trends in the tropics. Our results contradict a recent claim that all simulated temperature trends in (...) the tropical troposphere are inconsistent with observations. This claim was based on the use of older radiosonde and satellite datasets and on two methodological errors: the neglect of observational trend uncertainties introduced by interannual climate variability and application of an inappropriate statistical “consistency test”.This emerging reconciliation of models and observations has two primary explanations. First, because of changes in the treatment of buoy and satellite information, new surface temperature datasets yield slightly reduced tropical warming relative to earlier versions. Second, recently developed satellite and radiosonde datasets now show larger warming of the tropical lower troposphere. In the case of a new satellite dataset from remote sensing systems, enhancedRSS warming is due to an improved procedure of adjusting for inter-satellite biases. When the RSS-derived tropospheric temperature trend is compared with four different observed estimates of surface temperature change, the surface warming is invariably amplified in the tropical troposphere, consistent with model results. Even if we use data from a second satellite dataset with smaller tropospheric warming than in remote sensing systems RSS, observed tropical lapse rates are not significantly different from those in all model simulations.Our results contradict a recent claim that all simulated temperature trends in the tropical troposphere and in tropical lapse rates are inconsistent with observations. This claim was based on the use of older radiosonde and satellite datasets and on two methodological errors: the neglect of observational trend uncertainties introduced by interannual climate variability and application of an inappropriate statistical “consistency test”. (shrink)

Based on the hypotheses that (1) a physiological organization exists inside each activity of daily life and (2) the pattern of evolution of physiological variables is characteristic of each activity, pattern changes should be detected on daily life physiological recordings. The present study aims at investigating whether a simple segmentation method can be set up to detect pattern changes on physiological recordings carried out during daily life. Heart and breathing rates and skin temperature have been non-invasively recorded in volunteers following (...) scenarios made of “daily life” steps (13 records). An observer, undergoing the scenario, wrote down annotations during the recording time. Two segmentation procedures have been compared to the annotations, a visual inspection of the signals and an automatic program based on a trends detection algorithm applied to one physiological signal (skin temperature). The annotations resulted in a total number of 213 segments defined on the 13 records, the best visual inspection detected less segments (120) than the automatic program (194). If evaluated in terms of the number of correspondences between the times marks given by annotations and those resulting from both physiologically based segmentations, the automatic program was better than the visual inspection. The mean time lags between annotation and program time marks remain <60 s (the precision of annotation times marks). We conclude that physiological variables time series recorded in common life conditions exhibit different successive patterns that can be detected by a simple trends detection algorithm. Theses sequences are coherent with the corresponding annotated activity. (shrink)

Progressive supranuclear palsy is a movement disorder with prominent tau neuropathology. Brain diseases with abnormal tau deposits are called tauopathies, the most common of which is Alzheimer's disease. Environmental causes of tauopathies include repetitive head trauma associated with some sports. To identify common genetic variation contributing to risk for tauopathies, we carried out a genome-wide association study of 1,114 individuals with PSP and 3,247 controls followed by a second stage in which we genotyped 1,051 cases and 3,560 controls for the (...) stage 1 SNPs that yielded P ≤ 10-3. We found significant previously unidentified signals associated with PSP risk at STX6, EIF2AK3 and MOBP. We confirmed two independent variants in MAPT affecting risk for PSP, one of which influences MAPT brain expression. The genes implicated encode proteins for vesicle-membrane fusion at the Golgi-endosomal interface, for the endoplasmic reticulum unfolded protein response and for a myelin structural component. © 2011 Nature America, Inc. All rights reserved. (shrink)

The Toronto experience suggests that there may be several general lessons for academic health sciences complexes to learn from the Olivieri/Apotex affair regarding the ethics, independence, and integrity of clinical research sponsored by for profit enterprises. From a local perspective, the OAA occurred when there already was a focus on the complex and changing relationships among the University of Toronto, its medical school, the fully affiliated teaching hospitals, and off campus faculty because of intertwined interests and responsibilities. The OAA became (...) a catalyst that accelerated various systemic reforms, particularly concerning academic/industry relations. In this article, the evolving governance framework for the Toronto academic health sciences complex is reviewed and these policy and process reforms discussed. These reforms have created collaborative activity among research ethics boards and contract research offices of the partner institutions, and allowed the joint university/hospital ethics centre to play a role in governance and policy, while respecting the missions and mandates of the involved institutions. Although few of the policies are dramatically innovative, what is arguably novel is the elaboration of an overarching governance framework that aims to move ethics to a central focus in the academic complex. Time alone will tell how sustainable and effective these changes are. (shrink)

Background: Post-traumatic stress disorder is a prevalent, debilitating, and costly psychiatric disorder. Evidenced-based psychotherapies, including Cognitive Processing Therapy, are effective in treating PTSD, although a fair proportion of individuals show limited benefit from such treatments. CPT requires cognitive demands such as encoding, recalling, and implementing new information, resulting in behavioral change that may improve PTSD symptoms. Individuals with PTSD show worse cognitive functioning than those without PTSD, particularly in acquisition of verbal memory. Therefore, memory dysfunction may limit treatment gains in (...) CPT in some individuals with PTSD. Methods and Analysis: Here, we present a protocol describing the Cognition and PsychoTherapy in PTSD study, a prospective, observational study examining how cognitive functioning affects treatment response in CPT for PTSD. The study aims to recruit 105 outpatient veterans with PTSD between the ages of 18 and 70 years. Prior to beginning 12 sessions of CPT, Veteran participants will have standardized assessments of mood and functioning and complete a comprehensive neurocognitive battery assessing episodic learning, attention and speed of processing, language ability, executive control, and emotional functioning. This study aims to fill gaps in the current literature by: examining the specificity of memory effects on treatment response; exploring how baseline cognitive functioning impacts functional outcomes; and examining potential mechanisms, such as memory for treatment content, that might explain the effects of baseline memory functioning on PTSD symptom trajectory. Discussion: If successful, this research could identify clinically relevant neurocognitive mechanisms that may impact PTSD psychotherapy and guide the development of individualized treatments for PTSD. (shrink)

Biological ontologies are used to organize, curate, and interpret the vast quantities of data arising from biological experiments. While this works well when using a single ontology, integrating multiple ontologies can be problematic, as they are developed independently, which can lead to incompatibilities. The Open Biological and Biomedical Ontologies Foundry was created to address this by facilitating the development, harmonization, application, and sharing of ontologies, guided by a set of overarching principles. One challenge in reaching these goals was that the (...) OBO principles were not originally encoded in a precise fashion, and interpretation was subjective. Here we show how we have addressed this by formally encoding the OBO principles as operational rules and implementing a suite of automated validation checks and a dashboard for objectively evaluating each ontology’s compliance with each principle. This entailed a substantial effort to curate metadata across all ontologies and to coordinate with individual stakeholders. We have applied these checks across the full OBO suite of ontologies, revealing areas where individual ontologies require changes to conform to our principles. Our work demonstrates how a sizable federated community can be organized and evaluated on objective criteria that help improve overall quality and interoperability, which is vital for the sustenance of the OBO project and towards the overall goals of making data FAIR. Competing Interest StatementThe authors have declared no competing interest. (shrink)

We examined how the cultural dimension of universalism–particularism influences managers’ attitudes toward relational favoritism. Paradoxically, we found in a survey study that Brazilian and Chinese managers perceived more negative consequences of relational favoritism than did American managers—even though the Brazilians and the Chinese perceived stronger particularistic cultural norms in their countries than Americans did in the United States. We attribute this pattern of results to “cultural reflexivity”—the ability of people from transforming economies to be culturally self-critical during a period of (...) dramatic societal change. This pattern of results also emerged in a scenario study in which we asked these same Brazilian, Chinese, and American participants to assess managerial succession decisions made by a General Manager. We varied the scenarios so that the promoted manager was either a colleague with no pre-existing relation with the GM or a colleague who was a relative, a close friend, from the same town, or from the same school. Consistent with the results of the survey study, we found that perceived cultural norms of particularism were negatively related to perceptions of fairness. In other words, Brazilians and Chinese, even while living in more particularistic cultures, were more harsh in judging relational favoritism. We conclude with a discussion on the implications of these paradoxical relationships. (shrink)

We describe and analyse how large herbivores strongly diminished a woody vegetation, dominated by the unpalatable shrub Sambucus nigra L. and changed it into grassland. Density of woody species and cover of vegetation were measured in 1996, 2002 and 2012 in the grazed Oostvaardersplassen. In 2002 and 2012 we also measured density and cover in an ungrazed control site. In 2002 we measured intensity of browsing and bark loss of Sambucus shrubs in the grazed and control sites. In the grazed (...) site the density of Sambucus and Salix spp. declined significantly between 1996 and 2012, and large areas changed into grassland. In the control site the density of Sambucus increased significantly during this period, the density of Salix spp. did not change, and the vegetation consisted of a mixture of woody species and a field layer dominated by tall herbs. In 2002 and 2012 the percentages of dead Sambucus shrubs were significantly higher in the grazed site than in the control site. In 2002 the percentages of twigs browsed and ring barked stems of Sambucus shrubs were significantly higher in the grazed site than in the control site. Our results show that debarking caused mature Sambucus shrubs to die, but that heavy browsing may have helped this process. Our results also point to a significant neighbour effect on the break down of Sambucus, suggesting that Aggregational Resistance and Associational Palatability were both active. Essential conditions for the break down of this woody vegetation were the presence of large herbivores, the low ratio between the areas of summer and winter feeding habitats and the competition amongst herbivores. Browsing may have been responsible for seedling death, as seedlings were found only in the control site and not on the old and newly established grasslands in the grazed site. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:IntroductionAnna Mastroianni (bio) and Jeffrey Kahn (bio)In this issue of the Kennedy Institute of Ethics Journal, we subject the work of the Advisory Committee on Human Radiation Experiments to examination from many angles. Nearly one year has passed since the release of the Committee’s final report and recommendations, and it seems an appropriate time to invite discourse and reflection on the influence and impact of the Committee and its (...) efforts. Our intent is to advance understanding of the Committee and its work, its place in the evolution of bioethics and public policy, as well as the broader legacy of restoring trust in the conduct of human subjects research.In 1993, President Clinton and Secretary of Energy Hazel O’Leary initiated an investigation of America’s involvement in radiation experiments on its citizens during the Cold War. The investigation resulted in the appointment of the Committee in January 1994. Some issues raised by these radiation experiments were brought to the attention of the nation by revelations contained in a Pulitzer Prize-winning series of newspaper stories about plutonium injections carried out by the government on allegedly unsuspecting subjects during the Cold War. The Committee faced a broad mandate, which included piecing together the history of Cold War radiation experiments and human subjects research, as well as recommending remedies for past wrongs and mechanisms to ensure that such wrongs could not be repeated in the future.This issue of the Journal consists of articles and accompanying commentaries on historical, philosophical, policy, and political aspects of the Committee’s work that are important to bioethics. This collection of articles, authored by Committee members, staff, and leading scholars, is designed to paint a picture of the breadth and complexity of the Committee’s efforts and to provide context and to stimulate discussion of significant issues.In the first article, Ruth Faden provides her unique perspective as chair of the Committee. She goes beyond the necessary overview and background of the Committee to reflect on the impact and meaning of the Committee’s work to bioethics and public policy.Much of the Committee’s effort was directed at gathering and uncovering information about the history of Cold War radiation experiments, an endeavor fairly foreign to bioethics but critically important to understanding the context in which to make moral judgments about the past. Jonathan Moreno and Susan Lederer discuss how the Committee’s work changed some of the traditional views of the history of research ethics. The commentary by Allan Brandt and Lara Freidenfelds further illuminates the value of understanding this recovered history. [End Page ix]In making moral judgments about the past, the Committee confronted complex questions about how to assess wrongdoing and the culpability of the government and its agents. Allen Buchanan explains why this was such a difficult but crucial task and how the Committee worked through some of the answers to these questions. His discussion illustrates the challenges to consensus in the committee decision-making process described in Ruth Macklin’s article in this issue on committees and consensus. Tom Beauchamp analyzes the frameworks for making retrospective moral judgments developed by two committees, the Advisory Committee and the University of California at San Francisco Ad Hoc Fact Finding Committee on World War II Human Radiation Experiments, and critiques their applications of the frameworks in the case of the plutonium injection experiments.The Committee recognized that in order to prevent wrongs seen in the past from occurring in the future, it would be necessary to understand the human subjects protections now in place. Nancy Kass and Jeremy Sugarman discuss the results of the Committee’s attempts to measure the operation and effectiveness of the current system for protection of human subjects. Paul Appelbaum comments on the relevance and value of the Committee’s empirical projects to contemporary human subjects research.The Committee’s work, and the products of any commission’s work, must be viewed partly in light of the place of commissions in bioethics scholarship and policymaking. Appointed commissions can have significant impacts on scholarly and public thinking, policymaking, and future direction, and bring high visibility to issues. It is important to realize that the conclusions of the Committee... (shrink)

People across the world seek out beautiful sounds in nature, such as a babbling brook or a nightingale song, for positive human experiences. However, it is unclear whether this positive aesthetic response is driven by a preference for the perceptual features typical of nature sounds versus a higher‐order association of nature with beauty. To test these hypotheses, participants provided aesthetic judgments for nature and urban soundscapes that varied on ease of recognition. Results demonstrated that the aesthetic preference for nature soundscapes (...) was eliminated for the sounds hardest to recognize, and moreover the relationship between aesthetic ratings and several measured acoustic features significantly changed as a function of recognition. In a follow‐up experiment, requiring participants to classify these difficult‐to‐identify sounds into nature or urban categories resulted in a robust preference for nature sounds and a relationship between aesthetic ratings and our measured acoustic features that was more typical of easy‐to‐identify sounds. This pattern of results was replicated with computer‐generated artificial noises, which acoustically shared properties with the nature and urban soundscapes but by definition did not come from these environments. Taken together, these results support the conclusion that the recognition of a sound as either natural or urban dynamically organizes the relationship between aesthetic preference and perceptual features and that these preferences are not inherent to the acoustic features. Implications for nature's role in cognitive and affective restoration are discussed. (shrink)